Healthcare Provider Details

I. General information

NPI: 1699179564
Provider Name (Legal Business Name): TRINITY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SIMMONSVILLE RD SUITE 400 B
BLUFFTON SC
29910-6908
US

IV. Provider business mailing address

7 SIMMONSVILLE RD SUITE 400 B
BLUFFTON SC
29910-6908
US

V. Phone/Fax

Practice location:
  • Phone: 843-816-1815
  • Fax:
Mailing address:
  • Phone: 843-816-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5680
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5680
License Number StateSC

VIII. Authorized Official

Name: MANDY MICHELLE RENTERIA'
Title or Position: OWNER/OPERATOR
Credential: LPCI
Phone: 843-816-1815